Wabamun and Area Community Exposure and Health Effects Program — Program Boundaries — WABAMUN AND AREA Wabamun 16 COMMUNITY EXPOSURE Lake Wabamun Stony Plain AND HEALTH EFFECTS 60 (N=72) ASSESSMENT PROGRAM (WACEHEAP)

No rth Saska tchewanR Devon iv e r

Calmar

Participant 39

Study Boundary Warburg Thorsby

Wabamun 133A I.R. ©

Note: Residences of participants have been slightly randomized to protect their confidentiality.

SUMMARY REPORT If you would like a full copy of the report, please contact AUGUST 2006 Jonathan Robb Health & Wellness 24th Floor, Telus Plaza North 10025 - Jasper Avenue , Alberta T5J 1S6

Phone: 780-422-4783 Fax: 780-427-1470 E-mail: [email protected] PAGE 2 WACEHEAP SUMMARY REPORT PAGE 19

The leadership of the Wabamun and Area Community Exposure Glossary of Terms and Health Effects Assessment Program (WACEHEAP) was di- rected by a variety of community partners including government, industry and community associations. The membership was com- posed of: Background sources: These are naturally occurring sources of air contaminants. They ♦ Alberta Environment are what we would expect to find if there was no local or regional ♦ Alberta Health & Wellness development in the area. ♦ Capital Health ♦ EPCOR Chronic Obstructive Pulmonary Disease (COPD): ♦ Health Long term lung disease usually caused by smoking. Symptoms in- ♦ Lake Wabamun Enhancement & Protection clude shortness of breath, increased mucus and coughing. COPD ♦ includes people who have chronic bronchitis and emphysema. ♦ Mewassin Community Action Council ♦ Local sources: Sources of air contaminants close or nearby to the residents. ♦ Paul First Nation Examples includes: outdoor fireplaces, wood burning furnaces, ♦ TransAlta vehicle exhaust, farming activities

Median: The Science Team and Steering Committee would also like Midpoint reading of all measurements collected for each of the air to gratefully acknowledge the contributions made by all monitors. volunteers in the Wabamun and surrounding area whose participation in the program was critical to the success of Regional sources: the program. These are industry sources of air contaminants or effects from other communities in the area.

Spirometry: Disclaimer: The organizations represented on the Steering Committee of A medical test used to measure the amount of air entering and exit- WACEHEAP are to be recognized for their contributions and support of the Wabamun and Area Community Exposure and Health Effects Assessment ing the lungs. Program. Although the program is directed by a multi-stakeholder consulta- tion process, this scientific report may not reflect the views of the organiza- tions represented on the Steering Committee. Any inquiries regarding the methods utilized in compiling and analyzing information and samples col- lected from the participants should be directed towards the Public Health Surveillance and Environmental Health Branch, Alberta Health and Wellness. PAGE 18 WACEHEAP SUMMARY REPORT PAGE 3

Multiple Sclerosis in Wabamun and WHAT IS WAC E H E A P ? Surrounding Area Some people who live in Multiple sclerosis (MS) is a disease Wabamun and surrounding which affects the brain and nerves. MS is area, have concerns about unpredictable and individuals can have a how coal-fired power sta- variety of symptoms. tions and oil & gas opera- Community members from Wabamun tions affect air quality and and surrounding area had concerns about impact on human health. the perceived high number of MS cases in their communities. To see if there is an increased rate of MS in this area, a health Goals of WACEHEAP: record analysis was completed. ♦ Measure exposure of residents from Wabamun and area to In the health record analysis, the rate of MS in Wabamun and sur- airborne chemicals and particulates; rounding area was compared to Alberta’s provincial average. • Examine the role indoor and outdoor air has on personal exposure to air contaminants; and How was this done? • Look at relationships between exposure to airborne chemicals and illness in people within Wabamun and surrounding area. ♦ The observed, or number of people with MS were identified from records of doctor visits from 1995 to 2004. ♦ An expected number based on the provincial rate was When was the calculated for that time period and by age and gender. data collected? May to How many people participated? What was found? November 2004 Total: 196 participants ♦ For Wabamun and surrounding area, the number of observed cases of MS was within the range of what is expected. ♦ 123 residents from urban and rural areas ♦ The number of cases found were not different than provincial rates in any age group. ♦ 73 residents of Paul First Nation PAGE 4 WACEHEAP SUMMARY REPORT PAGE 17

HOW WA S THIS DONE? Children’s Results Nicotine

♦ No nicotine was detected in blood samples. Volunteers were asked to: Mercury Wear personal air monitors to sample the air in their breathing zone for 24 ♦ For children and adults, common sources of mercury are dental hours per day for 7 consecutive days. fillings and eating fish. Have air monitoring stations set up ♦ Levels of mercury in the children’s blood, hair and urine sam- inside and outside their homes. ples were low. These values were also lower than children living in other areas. Give a sample of blood, urine and hair to determine exposure to contaminants. Arsenic Answer survey questions about their health, diet and other life- ♦ Common sources of arsenic are water style factors. from wells, seafood or mushrooms. ♦ Arsenic levels in urine were low and similar to those reported in children living in other places.

Where were the participants from? Immunoglobulin gamma (IgE) ♦ The children had higher IgE levels than the adult participants. Devon Warburg ♦ However, this is common in children, as IgE levels are high Spruce Grove Thorsby when we are young and then decline with age. Stony Plain Parkland County Wabamun Leduc County Paul First Nation Autoantibodies Calmar ♦ 25% (13/52) of children had positive autoantibody results. ♦ A comparative population was not available in the scientific lit- erature. Therefore, a clear understanding of these results is not possible without further investigation and samples. - A map showing the program area is at end of this report - PAGE 16 WACEHEAP SUMMARY REPORT PAGE 5

Children’s Biomarkers of Exposure ABOUT THE PARTICIPANTS The children’s component was a Two different participant groups were created: pilot project added to the Wabamun and area program. As children are Urban & Rural Paul First Nation still developing, they may have Paul First Nation is a unique population as they live closest to the higher rates of exposure and greater large industries in the area. Their length of residency in the area is contact with outdoors than adults. also longer than most residents (see below). These residents may Child participants were between the ages of 10 –12. also be involved in activities on the land, such as hunting or fishing, To participate, the child had to live and attend which could increase their exposure to some contaminants. school within the program boundaries for at least In both groups: one year. Permission from the child’s parent was also required. ♦ There was a high number of females ♦ How many children participated? Many participants were retired or homemakers ♦ 53 children participated. The children were ♦ split into two groups. A high number of the participants were 40 years of age or older ♦ 36 children from urban and rural areas ♦ within the program area Over 60% of all participants had a body mass index (BMI) of 25 or higher. A BMI of 25 or higher can indi- ♦ 17 children from Paul First Nation cate that an individual is overweight which could lead to health problems. Length of Residency What did the child participants do? ♦ 50% of urban and rural participants lived in the Waba- ♦ Give a sample of blood, urine and hair. mun program area for 10 years or more These samples were analyzed the same way as those submitted by the adults. ♦ 63% of the Paul First Nation participants lived in the program area for 15 years or more ♦ Personal air monitors were not worn by the children. Wearing these monitors Rates of Tobacco Use may be difficult for these participants. In ♦ 11% of urban and rural participants were smokers addition, this type of monitoring is also known to be unreliable with children. ♦ 65% of Paul First Nation participants were smokers PAGE 6 WACEHEAP SUMMARY REPORT PAGE 15

THE CONTAMINANTS SUMMARY & RECOMMENDATIONS

Five different air contaminants were investigated: —— Summary ——

Nitrogen Dioxide (NO2) 14 Volatile Organic Com- ♦ Personal exposure to the selected air contaminants is low in the pounds (VOCs) Sulfur Dioxide (SO2) Wabamun program area. Particulate matter (2.5µm) Ozone (O3) ♦ Personal exposure to air contaminants is very related to indoor air quality. ♦ No biological or neurocognitive effects directly linked to These air contaminants were selected because: exposure from air contaminants was discovered in the Waba- (1) They are of concern to local people in the area; mun program area sample. (2) There are government efforts to reduce levels in the ♦ There was an increased rate of visits to a physician for all respi- environment; and ratory illnesses, however not for health conditions such as (3) They can be measured accurately. asthma or COPD.

—— Recommendations —— Three air samples were taken for each participant:

1. Establish ongoing monitoring of personal exposure levels to air Indoor contaminants. Personal Monitors placed 2. Inform the general public about airborne contaminants and Monitors worn by inside the how to manage or reduce their exposure. participants all day to participant’s home. 3. Participate in the implementation of an organized approach to see what the level of community exposure and health effects assessment in the contaminants was in province in support of long-term comparisons with other areas their breathing zone. across the province. Outdoors 4. Adopt and promote the use of innovative methods and tech- Monitors placed nologies such as personal exposure monitoring to further our understanding of the relationship between air quality and outside the human health. participant’s home. PAGE 14 WACEHEAP SUMMARY REPORT PAGE 7

HEALTH RECORDS ANALYSIS NITROGEN DIOXIDE (NO2)

Nitrogen Dioxide or NO2 is produced by vehicles, oil and gas operations and power plants. Other sources are natural gas appli- A health record analysis is a way of ances and forest fires. determining if one community has a higher rate of illness compared to The table below shows the median level for the Wabamun and area program. Two values are provided for comparison: (1) the 2001 another one. Ft. and area program results and (2) applicable guide- line levels. As these levels are from multiple sources, please consult the WACEHEAP Final Report for more information. If the health of residents in the program area is being affected by air contaminants, the rates of asthma, bron- chitis, and/or chronic obstructive pulmonary disorder Personal Indoor Outdoor (median) (median) (median) (COPD) may be higher. 3 3 3 µg/m µg/m µg/m Wabamun (2004) 8.1 6.8 5.8 The Health Record Analysis Found: Ft. Saskatchewan (2001) 13.7 10.0 10.4 Guideline/Reference N/A 480* 400** ♦ Deaths from asthma, bronchitis or COPD were not Level 200*** higher in the program area compared to other communities. *one hr ** one hr average *** 24 hr average

♦ There was no increased risk of death from all causes, including respiratory disorders and heart disease. What influenced personal NO2 ♦ There was an increased rate of visits to the doctor for exposure? Exposure Sources of all respiratory disorders combined. This includes ♦ Indoor air levels (most NO2 colds, flus, bronchitis, or other similar illness. important factor) which ♦ Local sources or ♦ Although, the number of doctor visits for all respira- are affected by tobacco nearby sources tory disorders was high, visits specifically for asthma smoke and age of the (most important) and COPD were lower when compared to other com- home ♦ Regional and back- munities who have completed this program. ♦ Time spent outdoors at ground sources work (lesser concern) PAGE 8 WACEHEAP SUMMARY REPORT PAGE 13

SULFUR DIOXIDE (SO2) BIOMARKERS OF EFFECT & EXPOSURE

♦ Immunoglobulin gamma E (IgE ) is an Sulfur Dioxide or SO2 is formed when we use any antibody found in the blood which measures oil, gas or coal products which contain sulfur. allergy response.

♦ 88.5% of participants had intermedi- It is released into the air by diesel vehicles, gas plants, ate or low levels of IgE pulp and paper mills, power plants and boilers. ♦ Overall, IgE levels were related to cigarette smoking, having a history of asthma or other Personal Indoor Outdoor respiratory symptoms. (median) (median) (median) µg/m3 µg/m3 µg/m3 ♦ Autoantibodies are found in the blood and can cause damage to healthy tissues in our bodies. They can predict the develop- Wabamun (2004) 0.8 0.6 2.6 ment of diseases such as lupus, rheumatoid arthritis or similar conditions. Ft. Saskatchewan (2001) 0.7 0.3 2.3 ♦ 34% of participants were weakly positive for autoanti- Guideline/Reference N/A 1000* 450** bodies. Being positive for an autoantibody does not Level 150*** mean an individual will develop any illness. *5 min ** one hr average *** 24 hr average ♦ These results may have been influenced by the high number of females and participants over the age of 40 Exposure Sources who participated in the Wabamun program. Research has shown that females and people over 40 have higher of SO2 Local, regional and levels of autoantibodies background levels are What influences ♦ Many participants also reported having a cold or flu of equal importance as personal SO exposure? when the blood sample was taken. Illness can cause a sources of SO . 2 temporary increase in autoantibody levels. 2 ♦ Indoor levels (most important) ♦ Exposure to air contaminants (i.e. benzene, mercury) which are affected by having a was not higher for participants with positive results. garage attached to the home ♦ and age of the home A separate health record analysis revealed no increased rate of autoimmune diseases in the WACEHEAP area. ♦ Time spent outdoors at work Participants with disease specific autoantibodies will be notified of their results and advised to consult their family physician for further information. PAGE 12 WACEHEAP SUMMARY REPORT PAGE 9

BIOMARKERS OF EFFECT & EXPOSURE OZONE (O3)

Q: What are biomarkers of effect or exposure? Ozone or O3 is a naturally occurring gas found high in the atmosphere. It can also be produced indirectly by industries. A: They are indicators of the effects of contaminants on the human body. Since ozone can be easily broken down by other contaminants, outdoor levels are not good indicators of personal exposure. Q: What biomarkers were used in WACEHEAP? Personal Indoor Outdoor A: Two groups of biomarkers were examined: (median) (median) (median) 3 1. Participants provided blood, hair and urine samples. These µg/m3 µg/m3 µg/m samples were tested for different chemicals. Blood samples were also tested to see if participants had higher than normal Wabamun (2004) 3.2 1.6 43.9 immune or allergy responses. Ft. Saskatchewan (2001) 6.1 4.0 47.4 2. The function of participant’s lungs was examined. This was done by spirometry which measured the amount of air entering Guideline/Reference N/A 240* 160** or leaving the lungs. Level 125*** *one hour ** one hr average *** 8 hour What did we find?

♦ Seven chemicals were sampled for in the blood, urine and hair. What influences ♦ Nicotine, mercury, arsenic, benzene and toluene were personal O3 exposure? Exposure Sources detected in some participant’s samples but none were of O3 above normal levels. ♦ Indoor levels (most ♦ Background levels such important) which are as indoor levels were ♦ Xylene and ethylbenzene were not detected in any of affected by outdoor the most important the participant’s samples. levels source

♦ Amount of time spent ♦ No regional or local ♦ Lung function can be affected after prolonged exposure to outdoors sources were identified air contaminants. ♦ Contact with tobacco ♦ Over 90% of participants had lung function within the smoke normal range of 80-120% or higher. PAGE 10 WACEHEAP SUMMARY REPORT PAGE 11

PARTICULATE MATTER (PM2.5) VOLATILE ORGANIC COMPOUNDS

Particulate matter (PM) is a mixture of particles of varying Volatile organic compounds (VOCs) are a variety of sizes which float in the air. The size of these particles are chemicals which contain carbon. In total, fourteen (14) VOCs measured in microns. A micron (μm) is very small. A single were sampled for in the Wabamun area. Examples are benzene, strand of hair is 40 μm in width. toluene, nonane, and decane. When particles are smaller than 2.5 μm, they can be inhaled They can be released either naturally or as a by-product of indus- into the lungs. This may affect a person’s ability to breathe. trial activities. They are also often released into the air by products or materials found in the home. Examples include Particles of this size are found in tobacco smoke, aerosols, cleaning products, paints, carpets and glues. Tobacco smoke is forest fires and exhaust from power plants or oil and gas op- also a major source of VOCs. erations. For the 14 VOCs measured in the Wabamun program, important influences of personal exposure were: Personal Indoor Outdoor (median) (median) (median) The level of the VOC detected µg/m3 µg/m3 µg/m3 inside a participant’s home. Wabamun (2004) 28.7 10.7 6.5 This suggests the existence of Ft. Saskatchewan (2001) 15.1 7.0 6.6 indoor sources which affect personal exposure. Guideline/Reference N/A 100* 30** Level * one hour ** 24 hour Contact with tobacco Residents of Paul First Nation smoke or second hand may have an increased personal What influenced Exposure Sources smoke exposure to some VOCs because

personal PM2.5 exposure? of PM2.5 of personal activities occurring in the home (i.e. smoking, wood ♦ Use of tobacco products ♦ Background levels (most fueled furnaces) or secondhand smoke important) Having a garage (most important) ♦ Nearby or local sources attached to the home. (minor effect) ♦ An attached garage ♦ No regional sources These influences were common for all VOCs. For more details about individual ♦ Type of job or work were found VOCs, please see the WACEHEAP Final Report.